胃黏膜癌变过程中hTERT和相关基因表达的变化及其临床意义  

Expresion of hTERT and its associated genes in the tumorigenesis of gastric mucosa and its significance

作　　者：陈陵[1] 陈婷[1] 蔡永国[1] 汤旭东[1] 李晶晶[1] 房殿春[1] 罗元辉[1] 余松涛[1] 杨仕明[1] 

机构地区：[1]中国人民解放军第三军医大学西南医院全军消化病研究所,重庆400038

出　　处：《胃肠病学和肝病学杂志》2006年第5期443-447,共5页Chinese Journal of Gastroenterology and Hepatology

基　　金：国家自然科学基金资助项目(30470797)

摘　　要：目的探讨端粒酶逆转录酶(hTERT)、c-myc、bcl-2、NF-κB蛋白在正常胃黏膜(normalmucosa,NM)、肠化(intestinalmeta-plasia,IM)、异型增生(dysplasia,DYS)、早期胃癌(earlygastriccancer,EGC)和进展期胃癌(advancedgastriccancer,AGC)中的表达水平、相互联系及其临床意义。方法经手术或胃镜病理证实的不同病变胃黏膜组织132例为研究对象(其中NM20例、IM30例、DYS15例、EGC24例、AGC43例),采用免疫组化SP法分别检测其hTERT、c-myc、bcl-2、NF-κB的表达水平,并对各指标阳性表达率、相关性及临床病理联系进行比较分析。结果在胃黏膜癌变过程中,除bcl-2外,hTERT、c-myc、NF-κB的表达随着胃黏膜病变程度的加重而逐渐增加,各组间比较差异显著;进一步分析表明hTERT与c-myc在IM、DYS、AGC等3组中具有显著的相关性(P<0·05),而hTERT与bcl-2、NF-κB在IM、DYS、EGC、AGC等各组中均无显著的相关性(P>0·05);临床病理分析表明,hTERT在低分化及未分化中的表达显著高于高、中等程度分化(P<0·05),而与性别、年龄、肿瘤大小等无关。结论hTERT随着胃黏膜病变程度的加重,其阳性表达率逐渐增高,提示hTERT可能在胃黏膜癌变过程中具有重要意义,是胃黏膜癌变的早期事件;c-myc过表达可能是激活hTERT过表达的重要调节因素;hTERT不仅可以作为胃黏膜癌变的早期诊断指标,而且有可能成为胃癌或其他肿瘤基因治疗或免疫治疗的良好靶位。Objective To explore the protein expressions of hTERT, c-myc, bcl-2 and NF-κB and their correlation in tumorigenesis of gastric mucosa. Methods One hundred and thirty two gastric mucosa spacimens obtained from surgery or endoscopy, in which included 20 cases of normal mucosa （NM）, 30 cases of intestinal metaplasia （IM）, 15 cases of dysplasia （DYS） ,24 cases of early gastric cancer （EGC） and 43 cases of advanced gastric cancer （AGC）,were collected in the present study. Expressions of hTERT, c-myc, bcl-2 and NF-κB protein were determined by immunohistochemistry. Results In the gastric mucosa tumorigenesis,except for bcl-2, the positive rate of hTERT, c-myc, bcl-2 and NF-κB was increased in order from normal gastric mucosa to gastric cancer. There was a significant difference between each group. Further study showed that there was a significant correlation between hTERT and c-myc in the group of IM, DYS, EGC （ P 〈 0.001 ）, whereas there was no significant correlation between hTERT and bcl-2 or NF-κB in each group. Clinical pathological anslysis revealed that expression of hTERT was significantly higher in poorly differentiated cancer than in well or moderate differentiated group （ P 〈 0.001 ）. Conclusion hTERT may be an early event of tumorigenesis of gastric mucosa, c-myc may be involved in the activation of hTERT.

关 键 词：人端粒酶逆转录酶 胃癌 C-MYC 

分 类 号：R735.2[医药卫生—肿瘤]